What will help my weak back and sciatica?

Jane mugshot for JQAI am a 70-​year-​old woman and have had prob­lems with my back for 40 years. In my thirties I was twice put in a body plaster for six weeks for slipped discs. Recently I have begun suf­fer­ing with sci­at­ica and would like to know of any exer­cises that would help to strengthen my back again.

As you have a his­tory of back prob­lems, your first port of call really should be to an osteo­path or “sports” physio­ther­ap­ist to check out whether there is an under­ly­ing prob­lem need­ing atten­tion. Overwhelmingly, back pain is caused by a com­bin­a­tion of mus­cu­lar weak­ness and very minor dam­age such as a muscle strain from mak­ing a bad move­ment. Unfortunately the brain is notori­ously unre­li­able at inter­pret­ing pain mes­sages from the lower back, so we end up feel­ing severe pain with injur­ies that are lit­er­ally micro­scop­ic­ally small and which will heal per­fectly well by them­selves.

But once you’ve had prob­lems with your back, such as a “slipped disc” (usu­ally called her­ni­ation or pro­lapse these days), your back is more vul­ner­able to a repeat. As a post-​menopausal woman, you should also check your bone health with your GP. Osteoporosis (weakened bones) affects up to half of women at your age, and small back frac­tures often go undia­gnosed.

If you have had another slipped disc, you’ll most cer­tainly not be put in a body plaster again! We now under­stand that keep­ing still and doing noth­ing is just about the worst way to treat most back pain, includ­ing disc prob­lems. It’s really import­ant to keep on the move, to pre­vent everything from stiff­en­ing or seiz­ing up and main­tain sup­port­ing muscles in reas­on­able shape.

Assuming there’s no under­ly­ing issue, here’s some tips for how to help your back.

  • For pain relief, a very good pos­i­tion is the crook lie: lying face up on a car­pet or mat, with your knees bent and shins and feet rest­ing on a kit­chen chair
  • Strong abdom­inal muscles are cru­cial to sup­port your lower back. Sit slumped for­wards in a kit­chen chair, elbows rest­ing on thighs. Now cough and feel the tummy muscle below your belly but­ton con­tract. Cough again and pull that muscle inwards towards your spine as hard as you can. Hold for 5 and release. Keep prac­tising this, increas­ing the length of the hold, breath­ing all the time. Aim for 30-​second holds, while breath­ing. Then prac­tise lightly pulling in that muscle whenever you are out shop­ping, sit­ting watch­ing TV, pick­ing things up, wash­ing up, lying in bed etc. Click here for the full exer­cise
  • Back raises strengthen the long back muscles very effect­ively. Lie face down, elbows bent and palms flat by your ears. Check that your front hips and pubic bone are lightly press­ing into the ground. Raise your chest and head away from the ground, press­ing palms lightly to help, and hold for 5. Lower care­fully down and repeat. As you raise away, pull in that lower abs muscle. Keep breath­ing through­out. Repeat 10 times, rest, then do up to four more sets through­out the day – every day. Click here for the full exer­cise. You’ll notice improve­ments within a month.

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